Late primary arterial switch operation in patients with transposition of great arteries and intact ventricular septum

Background: This study aims to report the results of late arterial switch operation performed in patients with transposition of the great arteries and intact ventricular septum after the third week of life. Methods: Between January 2010 and November 2015, a total of 14 patients (8 boys, 6 girls; mean age 42 days; range 22 to 125 days) with the diagnosis of transposition of the great arteries and intact ventricular septum in whom arterial switch operation was performed after the postnatal third week were retrospectively analyzed using the hospital database. Results: Eight patients had severe cyanosis (SO2 <= 70%), 11 patients were receiving prostaglandin E-1 infusion, and four patients were on mechanical ventilation support at baseline. Balloon atrial septostomy was on three patients previously. Preoperative cardiac catheterization was performed on four patients. Twelve patients were transferred to the intensive care unit with opened chest postoperatively. The median duration of mechanical ventilation, intensive care unit and hospital stay were seven days, 12 days and 17 days, respectively. Peritoneal dialysis was performed on three patients. Three patients developed rhythm problems and three patients developed sepsis during the intensive care unit stay. One patient needed extracorporeal life support. No mortality was seen in any patient. Conclusion: Late arterial switch operation can be performed safely in patients with transposition of the great arteries and intact ventricular septum after a detailed evaluation and with an efficient, advanced, and suitable postoperative intensive care unit monitorization.